Integra Dialysis Center LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

INTEGRA DIALYSIS CENTER LLC

Practice address

1490 W 49TH PL
Hialeah, FL 33012-3148

Phone

(954) 274-6045

NPI assigned

Oct 8, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Socorro Miryam Mathews, APRN

Title

Administrator

Phone

(954) 274-6045

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Listed as

Integra Dialysis CenterCCN 682695

Overall star rating

2.0 of 5

Ownership

Profit

Certified

May 21, 2020

Medicare certification status

ActiveFrom the Provider of Services file

Dialysis stations

12

Locations

Networks

• HealthSun Health Plans Network

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Esteban J Diaz-Rivera, M.D, P.A

  • Nephrology Physician
  • Hialeah, FL
  • NPI 1932156999

  Dialysis facility

  Care Compare affiliation Name & address match

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1570492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570492800000",
    "number": "1801438130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 SW 183RD WAY",
            "city": "SOUTHWEST RANCHES",
            "state": "FL",
            "postal_code": "333311640",
            "telephone_number": "954-274-6045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1490 W 49TH PL",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330123148",
            "telephone_number": "954-274-6045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRA DIALYSIS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-08",
        "last_updated": "2019-10-08",
        "status": "A",
        "authorized_official_last_name": "MATHEWS",
        "authorized_official_first_name": "SOCORRO",
        "authorized_official_middle_name": "MIRYAM",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "954-274-6045",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Institute of Preventive Medicine, LLC
• Institute of Rehabilitation & Help
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• Tamara Insua, DMD
• Insulinic of Hialeah LLC
• Integrated Behavior Service Inc.
• Integrated Comprehensive Urgent Care, LLC.
• Integrated Healthcare Services LLC
• Integrated Regional Laboratories Pathology Services, LLC
• Integrated Rehabilitation Center

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Hialeah, FL
• Providers in Hialeah, FL by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.